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Its first usage in the treatment of melasma dates back to 1979.[] It has been reported to be efficacious as oral medication, localized intradermal microinjection[] or intravenous formulation (not available in India).[] Several mechanisms of action have been proposed for this medication, and those have been tabulated below [Table 2].[] Several authors have demonstrated the efficacy of oral TA in melasma [Table 3]

IGF-1 LR3 is better able to stimulate the type 1 IGF receptor and thus induce a higher level of intracellular signaling, cell proliferation and inhibition of apoptosis

It also plays a role in energy homeostasis and cellular metabolism

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